Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Plasmacytomas are localized neoplastic proliferations of monoclonal plasma cells. When multifocal, the process is referred to as multiple myeloma. These lesions exhibit a pattern of antigen expression and cytomorphology that usually leads to a ready diagnosis. However, potentially troublesome variations in immunophenotype occur. We describe a case of a plasmacytoma from a patient who presented with sudden onset of pain and a lytic lesion of the left proximal humerus. Hematoxylin and eosin-stained sections showed a lymphoproliferative lesion composed of large lymphoid cells, some with plasmacytoid and immunoblastic features. The lesion also showed significant mitotic activity. Immunohistochemical staining was positive for CD45 (LCA), CD56 (N-CAM), CD43 (MT1), and cytokeratin CAM5.2. There was also clonal staining for lambda light chains. In addition, flow cytometric analysis showed positivity for myeloid markers such as CD13, CD33, CD38, and CD138. Significant negative markers include CD20 (L26), CD45RO (UCHL-1), and CD79alpha. The unusual phenotypic features of this plasmacytoma illustrate potential diagnostic pitfalls. It is important to fully study such lesions to correctly classify them, because this has significant impact on prognosis and management.
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PMID:Plasmacytoma with aberrant expression of myeloid markers, T-cell markers, and cytokeratin. 1137 26

The author describes 4 cases of thoracic back pain. All 4 had significant night pain, and 3 of the 4 presented with an upper motor neuron lesion of the lower limbs subsequestly diagnosed as a primary vertebral tumor. All lesions were well demonstrated on CT examination and were proved to be chordoma, lymphoma, solitary plasmacytoma or aneurysmal bone cyst. Awareness of primary thoracic tumours is important, as early recognition may prevent irreversible damage to the cord.
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PMID:Persistent back pain in adults: Four case reports. 1246 63

A 69-year-old woman visited a hospital with a complaint of left abdominal dull pain. A computed tomographic scan demonstrated a large tumor with central necrosis in the left retroperitoneum, and an angiography revealed hypervascular tumor which was fed from splenic, left renal, left gastric and left colic arteries. Renal cell carcinoma with extrarenal progression was pre-operatively suspected, and a resection was attempted. However, since the celiac artery was involved in the tumor, only a biopsy was performed. The histopathological finding of the biopsy specimen was a plasmacytoma. A combination of chemotherapy and radiation therapy resulted in a marked reduction of the tumor. There was no evidence of tumor progression one year after the chemotherapy.
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PMID:[A case of retroperitoneal extramedullary plasmacytoma]. 1497 56

A 35-year-old man presented with insidious onset of severe sacral pain. Plain radiography, computed tomography, and magnetic resonance imaging revealed a large, locally invasive mass within the sacrum. Skeletal scintigraphy showed marked hyperemia and minimal peripheral osteoblastic activity of the sacral mass. An F-18 FDG PET study was performed for further assessment and clinical staging. The mass demonstrated high glucose avidity consistent with a high-grade tumor. Histologic examination confirmed the lesion to be a plasmacytoma. Solitary plasmacytoma of bone occurs predominantly in older patients involving the axial skeleton. This case is interesting in view of the large dimension, sacral involvement, the young age of the patient, and the appearance of this lesion across multiple imaging modalities.
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PMID:Solitary plasmacytoma of bone: an unusual cause of severe sacral pain in a young man. 1610 Apr 81

Total 14 cases of myeloma in young age group (<40 years) have been reported out of 178 cases of myeloma in a time period of 7 years (1993-1999). Males predominated overfe males. Like adult myeloma, patients presented mostly with the backache, pain in pelvis, lower spine and weakness in about 60% of cases followed by swelling of bone in 40% of cases. One case presented with bleeding gum, malena and hepatosplenomegaly and was diagnosed as plasma cell leukemia. Radiological examination revealed lytic lesion in almost all the cases with fracture femur and rib in 28.57% of cases. Anaemia and raised ESR was noted in all the cases. Myeloma typing revealed IgG myeloma in 10 cases, light chain myeloma in 3 cases and IgA myeloma in one case. None of the patient was traceable after 2 years. Thus our study concludes that myeloma in the young age in India occurs in increased frequency and clinically presents just like adult and elderly myeloma, but serologically are predominantly of IgG type. There is also an increased frequency of solitary plasmacytoma as compared to adult myeloma.
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PMID:Myeloma in young age. 1676 40

We conducted a review of the Leeds Regional Bone Tumour Registry for primary bone tumours of the spine since establishment in 1958 until year 2000. To analyse the incidence of primary tumours of the spine and to record the site of occurrence, sex distribution, survival and pathology of these tumours. Primary tumours of the spine are particularly rare, accounting for between 4 and 13% of published series of primary bone tumours. The Leeds Bone Tumour Registry was reviewed and a total of 2,750 cases of bone tumours and tumour-like cases were analysed. Consultants in orthopaedic surgery, neurosurgery, oncology and pathology in North and West Yorkshire and Humberside contribute to the Registry. Primary bone tumours of the osseous spine constitute only 126 of the 2,750 cases (4.6%). Chordoma was the most frequent tumour in the cervical and sacral regions, while the most common diagnosis overall was multiple myeloma and plasmacytoma. Osteosarcoma ranked third. The mean age of presentation was 42 years and pain was the most common presenting symptom, occurring in 95% of malignant and 76% of benign tumours. Neurological involvement occurred in 52% of malignant tumours and usually meant a poor prognosis. The establishment of Bone Tumour Registries is the only way that sufficient data on large numbers of these rare tumours can be accumulated to provide a valuable and otherwise unavailable source of information for research, education and clinical follow-up.
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PMID:Primary bone tumours of the spine: a 42-year survey from the Leeds Regional Bone Tumour Registry. 1686 76

This is the first report of feline solitary plasmacytoma of bone. We describe the clinical, clinico-pathological, radiographic and pathological findings of two successfully treated cats with long-term follow-up. The first case presented with spinal pain and neurological deficits. Radiographs demonstrated sclerosis of lumbar vertebra L6 and a myelogram confirmed interference to flow of contrast in the L4-7 region. A biopsy of L6 revealed neoplastic plasma cell infiltration. There was no evidence of paraproteinaemia on serum protein electrophoresis. The cat underwent hypofractionated megavoltage radiotherapy. Clinical signs resolved completely and 4 years after diagnosis the cat remains well and has no electrophoretically detectable paraproteinaemia. The second case presented with neurological deficits of the tail and spinal radiographs revealed extensive osteolysis of the sacrum. A biopsy of sacral bone demonstrated neoplastic plasma cell infiltration. The animal was normoglobulinaemic. The cat improved clinically with induction chemotherapy (melphalan and methylprednisolone). The same chemotherapeutics were continued at maintenance doses for 4.3 years, at which time there was recurrence of neurological deficits and a palpable sacral mass. Cytological examination of a fine needle aspirate confirmed recurrence of plasma cell neoplasia. A low concentration monoclonal paraproteinaemia was detected. Vincristine was administered resulting in resolution of neurological deficits and a palpably smaller sacral mass. Eighteen months into vincristine therapy, there was recurrence of clinical signs and the cat was euthanased, more than 6 years after the initial diagnosis.
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PMID:Solitary plasmacytoma of bone in two successfully treated cats. 1688 73

A 53-year-old woman was admitted to our hospital with left chest-wall pain. Computed tomography scans showed a homogenous mass on the left chest-wall with pleural effusion. Laboratory data showed anemia, hypercalcemia, and high levels of serum IgG. An IgG-lambda monoclonal protein was detected with serum immunoelectrophoresis. In addition, the serum level of neuron specific enolase (NSE) was elevated. A chest-wall tumor biopsy and a bone marrow aspiration revealed diffuse proliferation of atypical plasma cells, which were positive for cytoplasmic CD38 and IgG-lambda. The patient was diagnosed as having IgG-lambda type multiple myeloma with a chest-wall plasmacytoma. Immunostaining revealed diffuse NSE staining in the cytoplasm of the atypical plasma cells. These findings suggested that the myeloma cells produced NSE. The left chest-wall tumor and bone marrow myeloma cells disappeared following several courses of chemotherapy and radiotherapy and the serum levels of IgG and NSE also normalized. No recurrence of the multiple myeloma was seen after an autologous peripheral blood stem cell transplantation. This is the second report of an NSE-producing multiple myeloma. Interestingly, our case has similar clinical phenotypes with the previously reported case, such as chest-wall plasmacytoma, pleural effusion and hypercalcemia.
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PMID:[A neuron specific enolase-producing multiple myeloma]. 1709 78

Plasmacytoma of the atlas with pathological fracture has not been previously reported. A 72-year-old man was admitted to our clinic with a 5-month history of occipital headache. Neurologic examination revealed mild occipital neuralgia, difficulty with movements of the cranium, hyperactive deep tendon reflexes, but no Babinski sign. Magnetic resonance imaging (MRI) of the cervical spine showed a 1x2 cm well-circumscribed extradural mass, with lytic destruction and fracture of the lateral mass of C1. Preoperatively dynamic cervical radiographs showed no instability. Using a transcondylar approach, the tumor was removed, and posterolateral fixation and fusion (using iliac autograft) was performed. Biopsy was reported as plasmacytoma. The patient was pain-free with bony fusion 3 years after surgery. This paper presents a pathologic fracture of C1. Although the primary treatment of plasmacytoma is non-surgical, the need for tissue diagnosis in relevant areas may dictate an open biopsy procedure. Such cases may require a decompression and reconstruction procedure.
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PMID:Pathological fracture of the atlas secondary to plasmacytoma. 1734 72

Metastasis to bone is a common event in the natural history of nearly all neoplasms, which often greatly affects the patient's quality of life. Bone metastases can cause pain and pathological fractures, or even a cord compression syndrome with severe neurological symptoms. The treatment of metastatic disease requires a multidisciplinary approach that addresses systemic and local disease. On a basis of available literature as well as own research current opinions on this subject has been presented in these paper.Where the treatment objective is pain relief, a single 8 Gy treatment is recommended as the standard dose-fractionation treatment of symptomatic but uncomplicated bone metastases. External beam irradiation achieves pain palliation in more than 75% of patients. Radiotherapy with doses of 40-50 Gy results in remineralization in 60-80% of patients 4-8 weeks after irradiation. The role of radiotherapy in the treatment of primary bone cancer is limited. The choice of the best local treatment of Ewing's sarcoma of bone remains a controversial issue. Surgery should always be considered in the local treatment of Ewing's sarcoma. Postoperative radiation therapy must be added when surgical margins are inadequate. Radiotherapy is used in the treatment of plasmacytoma, chordoma and chondrosarcoma.
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PMID:Role of radiotherapy in the treatment of osteolytic damage due to bone tumors. 1761 44


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